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The history of the NHS in England

The NHS in 2000s - the new millenium

The robotic arm is used for the first time in 2007

The introduction of a robotic arm in 2007 leads to groundbreaking heart operations at St Mary’s Hospital, London. Find out more in the section below, the NHS in 2007.

The NHS in 2000

NHS walk-in centres introduced

NHS walk-in centres (WiCs) offer convenient access to a range of NHS services. They used to be managed by primary care trusts (PCTs), but since April 1 2013 this role falls to Clinical Commissioning Groups (CCGs). WiCs are usually run by nurses and are available to everyone. You do not need an appointment or to be registered to visit a walk-in centre. Most centres are open every day of the year and are situated in convenient locations, giving patients access to services outside regular office hours

There are around seven million attendances at type 3 A&E services (i.e WiCs, Urgent Care Centres and Minor Injury Units) in England, dealing with minor illnesses and injuries.

Find out more about emergency and urgent care services in England

The NHS Plan

The NHS Plan brings about the biggest change to healthcare in England since the NHS was formed in 1948. It sets out how increased funding and reform will eliminate geographical inequalities, improve service standards and extend patient choice. It outlines the vision of a health service designed around the patient.

Read about the NHS Plan principles on the National Archives website.

The NHS in 2002

Primary care trusts launched

Primary care trusts (PCTs) oversee 37,000 GPs and 21,000 NHS dentists. PCTs control 80% of the total NHS budget. They liaise with the private sector when contracting out services. As local organisations, they understand the needs of their community, so can ensure that organisations providing health and social care services work effectively.

PCT's were abolished on April 1 2013. Read more about today's authorities and trusts

First successful gene therapy

In April 2002, the first successful gene therapy is carried out at Great Ormond Street Hospital, London. It cures 18-month-old Rhys Evans of 'bubble boy' disease (severe combined immunodeficiency, or SCID).

First pilot scheme for free choice

The first pilot scheme for free choice is introduced. Patients facing a wait of more than six months are given the choice of going to an alternative provider for faster treatment. 

National Programme for IT launched

The Wanless report, examining future trends affecting the health service in the UK over the next two decades, is published in April 2002 and includes several key recommendations for IT in the NHS. As a result of this report, in June 2002 the Department of Health publishes its new strategy for developing IT in the NHS, laying the foundations for the National Programme for IT. The programme is formally established in October 2002. Its task is to procure, develop and implement modern, integrated IT infrastructure and systems for all NHS organisations in England. 

Also read about the Dismantling the NHS National Programme for IT in 2011.

Four-hour target for A&E departments

The four-hour target to ensure that no patient spends more than four hours in an accident and emergency (A&E) department from arrival to admission, transfer or discharge is set in the NHS Plan in 2000.

In 2003, a 98% minimum operating figure is set to allow for the minority of patients who clinically need more than four hours in A&E.
 
The target becomes an operational standard in 2005. In the 2006/07 year, national performance against the operational standard is 98.2% (all types of A&E). For the year 2007/08, across all A&E types, including those provided by the independent sector, performance against the operational standard is 97.9%.

Read more about emergency and urgent care services in England.

The NHS in 2004

First foundation trusts created

NHS foundation trusts, first introduced in April 2004, differ from other existing NHS trusts. They are independent legal entities and have unique governance arrangements. They are accountable to local people, who can become members and governors. Each NHS foundation trust has a duty to consult and involve a board of governors (including patients, staff, members of the public, and partner organisations) in the strategic planning of the organisation.

They are set free from central government control and are no-longer performance managed by health authorities. As self-standing, self-governing organisations, NHS foundation trusts are free to determine their own future.

They have financial freedoms and can raise capital from both the public and private sectors within borrowing limits determined by projected cash flows and therefore based on affordability. They can retain financial surpluses to invest in the delivery of new NHS services.

Foundation trusts are currently overseen by Monitor.

The NHS in 2006

Extended patient choice

Where appropriate, people have the choice of at least four providers when referred for planned hospital care. In May 2006, an Extended Choice Network is launched. This allows patients to choose from NHS foundation trusts and independent sector treatment centres, in addition to local options. In August, the scheme expands further, with more independent providers added. Find out more about patient choice of hospital

NHS Bowel Cancer Screening Programme launched

The NHS Bowel Cancer Screening Programme is one of the first national bowel screening programmes in the world and the first cancer screening programme in England to include men as well as women.

All men and women aged 60 to 69 are expected to be included by December 2009, meaning around two million men and women will be screened and an estimated 3,000 cancers detected every year. The programme will be extended from 2010 to include men and women aged 70-75 years.
 
Find out more in the How screening for bowel cancer works section. 

Vaccination of babies against pneumococcal meningitis begins

A pneumococcal vaccination catch-up-programme is introduced to ensure that children up to two years of age, who are at most risk from pneumococcal infection, are also offered the vaccine.

Improving Access to Psychological Therapies (IAPT) programme

The Improving Access to Psychological Therapies (IAPT) programme begins in 2006, providing easy access to talking treatment on the NHS for people suffering from depression and anxiety disorders.

The NHS in 2007

Launch of NHS Choices health information website

The NHS Choices website is launched in June 2007 by the Department of Health. The service is intended to help people make choices about their health, from lifestyle decisions about smoking, drinking and exercise, to finding and using NHS services in England

Since the integration of the online arm of NHS Direct in October 2008, NHS Choices has provided a single public website for health and the NHS in England.

Smoking ban

From July 1 2007, smoking is banned in restaurants, pubs and other public places in England

Also read:

Introduction of robotic arm leads to groundbreaking heart operations

A revolutionary robotic arm is used at St Mary’s Hospital, London, to treat patients for fast or irregular heartbeats.

Use of robotic arm during surgeryLess risky than more invasive techniques, it works by inserting several fine wires into a vein in the groin. These are then guided to the heart, where they deliver an electric current to specific parts of the heart muscle. Cardiologists control the robot arm through a computer using a joystick. In future, the system could be automated so that the robot guides the wires to a place in the heart chosen by the doctor from images on a computer screen.

Around 50,000 people develop an irregular heartbeat each year. It's a major cause of strokes and heart attacks.

The NHS in 2008

Free choice 

Free choice is introduced on April 1 2008. Patients referred by their GP for their first consultant-led outpatient appointment can choose from any hospital or clinic that meets NHS standards. 

The NHS at 60

On July 5 2008, the NHS celebrates its 60th birthday. Local events take place across the country, and NHS staff and patients celebrate at Westminster Abbey and 10 Downing Street. Also read about the NHS 65th anniversary

Next Stage Review

Lord Darzi’s Next Stage Review (PDF, 2.69Mb) is the biggest consultation process in the history of the NHS. It involves 60,000 staff, clinicians, patients and members of the public and aims to improve the quality of NHS services.

HPV vaccination programme

In September 2008, a national programme to vaccinate girls aged 12-13 against human papilloma virus (HPV) is launched to help prevent cervical cancer.

There is also a three-year catch-up campaign that will offer the HPV vaccine (also known as the cervical cancer jab) to 13- to 18-year-old girls. 

Target to halve MRSA infections in England is met

The target set in 2003/04 to halve MRSA bloodstream infections in England is met in September 2008.

NHS screening anniversary

2008 marks the 20th anniversary of the NHS breast and cervical screening programmes. Since 1988, more than 70 million women have been screened and more than 100,000 breast cancers and 400,000 significant cervical abnormalities have been detected.

The NHS in 2009

Change4Life

Change4Life aims to prevent people from becoming overweight by encouraging them to eat more healthily and exercise more. The Change4Life advertising campaign begins on January 3 2009. 

Same-sex accommodation programme

hospital wardThe Department of Health pledged to eliminate all remaining mixed-sex hospital accommodation by April 2010. In January 2009, the health secretary Alan Johnson announces plans to help hospitals eliminate mixed-sex accommodation.

These plans include:

  • funding for hospitals to improve patient privacy and dignity
  • specialised advice and support to help hospitals make the most of their resources 
  • introducing performance measures from April 2010
  • monitoring patients' experience of hospital accommodation  

Find out more about same-sex hospital accommodation, including data on which hospitals still fail in providing single sex accommodation.

Design for patient dignity (Between 2009 -April 2010)

Making the hospital experience better by helping patients feel less vulnerable and more dignified. The Design Council, working in partnership with the Department of Health, commissioned six teams of designers and manufacturers, as well as healthcare design specialists from the Royal College of Art Helen Hamlyn Centre to develop innovative new designs showing how different privacy and dignity issues could be solved.

Find out more the Design for patient dignity on the Design Council's website.

The NHS Constitution

The NHS Constitution was published on January 21 2009. 

For the first time in the history of the NHS, the constitution brings together in one place details of what staff, patients and the public can expect from the National Health Service. It also explains what you can do to help support the NHS, help it work effectively, and help ensure that its resources are used responsibly.

The Constitution sets out your rights as an NHS patient. These rights cover how patients access health services, the quality of care you’ll receive, the treatments and programmes available to you, confidentiality, information and your right to complain if things go wrong.

The NHS Constitution was last updated on April 1 2013 to reflect structural changes to the NHS in England.

Access the NHS Constitution and find out your rights to choice.

Stroke Act F.A.S.T. campaign

Stroke campaign posterThe Act F.A.S.T. campaign was launched in February 2009 and includes strong imagery to highlight the visible signs of stroke.

F.A.S.T., which stands for Face-Arm-Speech-Time, is a simple test to help people recognise the signs of stroke and understand the importance of emergency treatment. The campaign encourages people to call 999 as soon as possible. The sooner a stroke patient receives treatment, the better their chances are of surviving and reducing long-term disability.

Care Quality Commission launched

The Care Quality Commission (CQC) was launched in April 2009 as a new regulator for health, mental health and adult social care.

The new organisation aims to help regulate the quality of services. It brings together information from the monitoring and inspection of all health and social care services.

Patient Reported Outcome Measures (PROMs)

All NHS patients having hip or knee replacements, varicose vein surgery, or groin hernia surgery are being invited to fill in PROMs questionnaires. PROMs are Patient Reported Outcome Measures.

The NHS is asking patients about their health and quality of life before they have an operation, and about their health and the effectiveness of the operation afterwards. This will help the NHS measure and improve the quality of its care.

PROMs have been collected by all providers of NHS-funded care since April 2009

18-week waiting times

The NHS Constitution states that no one should wait more than 18 weeks for consultant-led NHS treatment. This means that your treatment should start no later than 18 weeks from the day your GP refers you (unless you choose to wait longer or there's a good medical reason to delay).

As a result, hospital waiting times are now the shortest since NHS records began. Being treated within 18 weeks of GP referral is a significant achievement considering that people often waited 18 months or more for an operation during the 1990s. 

New Horizons: better mental wellbeing, better mental healthcare

The New Horizons programme is a 10-year strategy to improve adult mental health services in England by 2020. New Horizons brings together local and national organisations and individuals to work towards a society that values mental wellbeing as much as physical health. 

In 2011, New Horizons was replaced with the Mental health outcomes strategy.

NHS Health Checks

The NHS Health Check for adults in England between the ages of 40 and 74 is being introduced. It will give you and your GP a clearer picture of your health, and will help you take action to reduce your risk of heart disease, stroke, type 2 diabetes and kidney disease.

Page last reviewed: 01/09/2013

Next review due: 01/09/2015

The Choice Framework 2013

The Choice Framework explains when you have a legal right to choice about treatment and care in the NHS. The legal right to choice doesn't apply to all healthcare services, however, where you do not have a legal right to choice you should at least be offered some choices, depending on what’s available locally.

NHS at 60

NHS at 60

Explore a collection of 60 extraordinary photographs to celebrate the 60th anniversary of the NHS.

Designing out superbugs

How practical designs for hospital furniture that are easier to clean are helping combat infections like MRSA

Regulators

Learn about the watchdogs that monitor the NHS and other public healthcare providers.

What does patient choice mean to you?

People talk about choices they have made for their health, in their lifestyle, their NHS treatment and of NHS services.

Media last reviewed: 21/09/2012

Next review due: 21/09/2014